Feasibility of reducing frailty components in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial (AD-HOMEX)

There is a need for interventions to reduce frailty in older people with Alzheimer's dementia (AD). The purpose of this study was to investigate the effect of a home-based multimodal exercise program for older adults with AD (AD-HOMEX) on frailty. A parallel single-blind randomized controlled trial comparing a home-based exercise program and usual care. A home-based program in Brazil. Forty individuals aged 65years or older with mild to moderate AD. The intervention group (IG) participated in a 16-week protocol involving three 60-minute sessions per week of progressive individualized physical exercises supervised by a physical therapist. The participants in the control group (CG) maintained their usual care. Frailty was assessed using the FRAIL questionnaire, the Edmonton Frail Scale (EFS) and a subjective assessment by the evaluator (SAE) at baseline and follow-up. Per-protocol analysis was performed. Thirty-five participants completed the program (IG = 16; CG = 19). Frailty improved in the IG based on the EFS (P = .004) and FRAIL (P ≤ .001). An interaction between group and time (P = .008) and a significant difference between times (P = .047) were found for the SAE responsiveness domain. An improvement in the classification of frailty (EFS and FRAIL) was found between times in the IG (P = .003) and between groups at follow-up (P = .027). A significant difference in the SAE classification was found between groups at follow-up (P = .034), with a worsening between times in the CG (P = .032). Interestingly, a more favorable frailty transition pattern was found in the IG based on both the EFS and FRAIL. AD-HOMEX seems to reduce frailty and improve frailty transition patterns. Our findings provide a further theoretical basis for designing home-based physical interventions as routine practice for older frail adults with AD. •AD-HOMEX seems feasible to reduce the frailty components in older people with AD.•This intervention improved frailty transition patterns in older people with AD.•High adherence was observed among participants with mild to moderate AD.